HomeMy WebLinkAboutBLD2007-00166 !UILDING PERMIT APPLICATIR Review TyN ML Ty 194
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Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD07-00166 Received Date: 4/20/2007
SITE ADDRESS: 211 N STROMBERG AVE
PORT TOWNSEND, 98368
OWNER: JERE B CHAMBERLIN PHONE: (360) 379-6702
MARY V CHAMBERLIN
211 N STROMBERG AVE
PORT TOWNSEND WA 98368-2613 IRONDALE
SUBDIVISION: Block: 143 Lot: 5-9
PARCEL NUMBER: 962114322 Section: 35 Township: 30 N Range: 01 W
CONTRACTOR: INTEGRITY HOMES & REMODELING PHONE: (360) 316-9472
124 SWANSON AVE
PORT TOWNSEND WA 98368
Contractor's License INTEGHR953PD Expires 10/4/2007
REPRESENTATIVE: DONALD CHARLTON PHONE: (360) 316-9472
124 SWANSON AVE
PORT TOWNSEND WA 98368
PROJECT DESCRIPTIOI' EXTENSION OF DINING ROOM ON EXISTING HOUSE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ADD MAIN:
VALUATION 5,000.00 ADD'L: HEAT TYPE:
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: # OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: PUD
BEDROOMS: BATHROOMS:
Exist: D. Exist: "..
Prop: ' Prop: V
Total: ,2, Total: 0,
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $111.25 KAS 04/20/07 39794 APpROVEDPlan Check $72.32 KAS 04/20/07 89794
State Building Code $4.50 KAS 04/20/07 39794 JUN 4 2007
Total: $188.07 Jefferson County planning
& Building Department
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Jefferson County Building Dion Permit Num.: BLD07-00166
Applicant: CHAMBERLIN
BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2003 International Building Codes
To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection.
Requests received after 7:00 AM will not be scheduled for that day's inspections.
ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries.
The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection
Inspection Item Date Approval Signature Notes
Ext. Shear Wall Nailing
Framing
Airseal —21-477
Insulation: Walls �.21 —07
Insulation: Floors
Insulation: Ceiling
FINAL INSPECTION 70611
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
CONDITIONS for Building Permit# :BLD07-00166
1.) No plumbing has been reviewed or approved for this project by Jefferson County Public
Health. Additional requirements may apply if plumbing is proposed.
2.) ALL COMPONENTS OF THE SEPTIC SYSTEM, INCLUDING RESERVE AREA ARE TO
BE COMPLETELY PROTECTED FROM VEHICULAR TRAFFIC OR MECHANICAL
DISTURBANCE.
3.) The application was reviewed by the Jefferson County Department of Community
Development staff on June1, 2007 for the potential presence of Environmentally Sensitive
Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an
initial Geographic Information Systems mapping review and an investigative site
inspection, the following ESAs were confirmed to be present on the subject property:
SARPA; Coastal SIPZ.
4.) The applicant is proposing to create or add zero square feet of impervious surface and
zero square feet of land disturbing activities.
5.) Jefferson County determined that this proposal is categorically exempt from review under
the State Environmental Policy Act(SEPA) pursuant to WAC 197-11-800(1)(b)(i).
6.) The site plan as submitted with the Remodel permit application on April 20, 2007has been
reviewed for consistency under the UDC, and has been approved by Jefferson County
Department of Community Development. Any modifications, changes, and/or additions to
the stamped, approved site plan dated June1, 2007 shall be resubmitted for review and
approval by Jefferson County Department of Community Development.
7.) This approval is for a interior remodel and extension of dining room only. Any future
permits on this site are subject to review for consistency with applicable codes and
ordinances and does not preclude review and conditions which may be placed on future
permits.
8.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
9.) Not more than 2 unlicensed vehicles shall be stored on any lot unless totally screened
from view of neighboring dwellings and rights-of-way. Such screening shall meet all
applicable performance and development standards specific to the district in which the
storage is kept, and shall be in keeping with the character of the area. Screening shall
meet the requirements of Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor
vehicles is prohibited except in those districts where specified as an autormobile wrecking
yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter
18.18 JCC, and such storage shall meet the requriements of JCC 18.20.100, Automobile
wrecking yards and junk (or salvage) yards. In no case, shall any such junk motor
vehicles be stored in a critical area.
.._:r ..
(c:riii& JEFFERSONSUNTYDEPARTMENT OF COMMUNITY DEVELOPMENT •ti �
621 Sheridan Street • Port Townsend • Washington 98368
360/379-4450 • 360/379-4451 Fax
�gS,�N��p� www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: Di - t
Project Description (include separate sheets as necessary):
z
koirent Tax I�rcel Property
Number: 9j t9 21( `T 3 22_ Size: l •C' 5 t:1 -- - '1.
� � - (acres/square feet)
Site Address and/or Directions to Property: 7
1
1 I A, : S'-�r-c:/� 2.-- , R�-- T >z tiG( �\ u k r\Z, c:r al .5-k1 "1 _ c r tc1D
Property Owner(s)of Record: ---leA t- i' � Ant-, ( IN c,v �2 It-�t let
Telephone: 3(,0 3-7r?-(;,77C Z Fax: email:
Mailing Address: 211 ill 4 _S-f r,-,-,A.13`4.-1 (k1,Z,.
Applicant/Agent(if different from owner): Oci.A.n(c C e,,H-FL-,
Telephone: 3�G1 - 3 it c� t) 2_ Fax: i -1
L email: ��: h c M.Lf (_t)
Mailing Address: (�� Si.i.'tiAsc., P✓'-&-.-i Inc�1 ("„,vAS2�c(, (Ai,� cJS3t, 3 I-}-�: Ccrn
What kind of Permit?(Check each box that applies
Auilding 0 Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit 0 Conditional Use[C(a),C(d),or Cj**
❑ Single Family 0 Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)**
❑ Commercial* 0 Boundary Line Adjustment
❑ Change of Use 0 Short Plat**
❑ Address 0 Road Approach 0 Binding Site Plan**
❑ Home Business 0 Cottagelndustry 0 Long Plat**
❑ Propane 0 Planned Rural Residential Development(PRRD)/Amendments**
❑ Sign 0 Plat Vacation/Alteration**
❑Allowed"Yes" Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions**
❑ Stormwater Management 0 Shoreline Management Substantial Development**
❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance
0 Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment
❑ Forest Practices Act/Release of Six-Year Moratorium ❑ Tree Vegetaion Request
*May require a Pre—Application Conference **Requires a Pre-Application Conference
Please identify any other local, state or federal permits required for this proposal,if known:
nn DESIGNATION OF AGENT
I hereby designate 110.6II LIinr--14- 7f to act/ as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE // ���— Date:
By signing this application orm,the w er/agent attests that the information provided herein,and in any attachments,is true and correct to the best of
his,her or it's knowledge. /Any matey I falsehood or any omission of a material fact made by the owner/agent with respect to this application packet
may result in this permit being null and void.
I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and
expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit.
I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the appli ion that sh pri oti /f, `
Signature: t —7r Date: /// 7/0
`o-7
The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon((one or more threatened or
endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the
"Endangered Species Act"or"ESA."Jefferson County makes no assurances to tie applicant that the actions that will be undertaken because this
permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-trans ab respon rity,f,orVtferingjand-9omplying with the ESA. The Applicant has read this disclaim and 'gns and dates it below.
'Signature: cJZ a_ -, Date: q 13 L' 7
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
_ ,
BUILDER STATEMENT
The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assuming the responsibility of the General Contractor for the proposed project.
Signature: Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: .4 t1 f- tiL.IA;l 4 lc('
IA-ter,r-;� 1 Nt4- '- Re_M�,�e..1to I L ( 30 ) 3i1G -`) -/72 (360 )�37c1 -cid�s3
MAILING' DD SS: 1 a L( ,SN,�,1;:1 4 1'rl 73t Asz EMAIL: �nTel rill h�iM 4-1 40( .1- ' c CO ✓l
l
CONTRACTOR'S LICENSE WAINS: y� 33
NUMBER: te,,�9``r c�>; 3 p 0 NUMBERC l '-
ARCHITECT/ENGINEER: 7 PHONE ( ) FAX: ( )
MAILING ADDRESS: EMAIL
Project Type: F9me Type: Bathrooms: Shoreline: Type of Sewage Disposal:
❑ New if'Wood Existing: 2. u Sewer
Si Addition ❑ Steel Proposed: 0 Bank LI Community System
❑ Alteration/Remodel ❑ Concrete Total: 2. Height: [Individual System
❑ Repair ❑ Masonry —AA SEP Permit# SE10 a 4-79
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: 2 Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: 0 A�� ri''Public
r t ` Total: :t.. 'V'1�— Name of System: P LktO
If this is a Commercial Project you must answer the following:
Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces:
Number of occupants(includes owners,tenants,employees,etc) Current Proposed
IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No
If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply:
i Underground Tank i Above ground Tank Size of Propane Tank:
i Heat Stove i Cook Stove i Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes / No
When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property
lines, tank location and size, distances from the propane tank to all property lines, buildings and septic system components,
including the reserve area.
Square Footage Current Proposed For Office Use Only Amount Revision
Main Floor Heated ' �,� I EH Bld App Review: F.
2n0 Floor Heated i Consistency Review: G
Other Heated Base fee:
Mezzanine Additional Section:
-
Heated Basement Plan Check fee:
Unheated Basement State Surcharge fee:
Other Unheated Pot Water Review fee: -_
Garage/Carport SUBTOTAL
LG , G 1
Decks 911/Rd Approach fee: _
�y�t.) Iht)
Other TOTAL: $ L}(fG C'
Receipt Number: ti l q4
Cash/Check Number: I 1
ESTIMATED COST(REQUIRED) ---- Date: t1 �G ,�
.Fair market value of all lab6r and materials foundation to finish '—
5..O ab a d-b Initials:
G:\PermitCcnter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc